Posts tagged AMA

Dialogue ensues

Here are some comments I recently posted in reply to some of the commentary on yesterday’s Freeman column. I repost them here because they are long and detailed enough that they may be of some independent interest.

In an early comment, John Irby writes:

If it was so that medical care and mutual aid was so easy to come by, then why was their a perception that the poor and elderly were dying sick in the streets?

It depends on what period this “perception” is supposed to apply to.

  1. If you’re referring to the heyday of the mutual aid societies in the late 19th century through the 1910s, the answer is simply that this “perception” exists because statists often promote bogus perceptions of crisis without much supporting data, in order to put over the need for their desired programs with the politicized public. Some actual data on the circumstances faced by the poor and elderly, rather than impressionistic and sensationalistic “perceptions” would be useful here. I have some actual data on how available these arrangements were to ordinary workers, which I present briefly in the article — typically between 20% and 50% of workers in major urban areas in English-speaking countries were covered, and these numbers were rapidly rising in the 1900s, prior to the political campaigns to eradicate the associations and raise medical prices. If you want a fuller presentation of the data, I recommend David Beito’s excellent book, From Mutual Aid to the Welfare State, especially Ch. 6, “The ‘Lodge Practice Evil’ Reconsidered.” If you have actual countervailing data that tends to cut against the conclusion I draw, feel free to present it, but if what you’ve got is just ill-specified “perceptions,” well, so what?

  2. If, on the other hand, you’re referring to the decades leading up to the passage of major government entitlement programs for the “poor and elderly” — programs like Social Security (1935) or Medicare (1965), then you need to keep in mind that these programs were introduced and rolled out decades after the non-corporate, grassroots, free-market alternatives that I discuss in the article had been deliberately dismantled by politically-driven campaigns — coordinated mainly by establishment medical guilds, using their power over government licensure of practitioners as their primary means of enforcement — to drive them out. (The blackballing campaigns against lodge-practice doctors in the U.S. ramped up in the mid-1910s and succeeded in forcing dramatic declines in lodge practice starting in the 1920s. See Beito, p. 124 et seq.) So, to the extent that government could point to a crisis of health care accessibility or affordability for the poor and elderly, just before the New Deal and Great Society transfer programs were created, it’s because government was pointing to a situation where the kind of grassroots, consensual social organizations that had made health care accessible to the poor and elderly had already been rubbed out by government in the decades prior. Once again, an example of government breaking your legs, then handing you crutches, and telling you, “See, without me you couldn’t even walk!”

John:

However I am not ready to drink the cool-aid …

I don’t want to be a dick about this, but can you not use that phrase when what you mean is I don’t accept your delusional beliefs? It’s an offhand jokey reference where the punchline is the murder of 276 children, and the senseless deaths of almost 1,000 people, just 30 years ago. Jokes like that suck.

John:

… and say that we need to rid ourselves of the FDA or of medical accreditation. Kevin Trudeau is a salesmen of alternative cures for a variety of ailments [etc., etc.]

The existence of quacks and dangerous drugs today, in spite of already-existing heavy government regulation, seems like an odd argument for relying on government regulation as a means of getting rid of quacks and dangerous drugs.

In any case, the free-market position is not that we need to get rid of drug testing or medical accreditation. The free-market position is that the state should not force any particular scheme for drug safety or efficacy testing, or for medical licensure, on you or me without our consent.

The important thing, from the standpoint of individualist principle, is that, if you want to pay for snake oil without any consideration of demonstrated effects, you should be free to do so. And if I want to spend money only on drugs that scientific research has demonstrated to be safe and effective, or on doctors who have garnered the recognition of their peers as honorable and competent professionals, then I should be free to patronize only those that consensual consumer-protection outfits and professional medical institutions have approved.

In a freed market, there will certainly be both drug testing and medical accreditation; it will simply be drug testing and medical accreditation that relies on informed choice, or education and persuasion, rather than on the force of the law. How do I know that such institutions will exist? Well, of course, because they already exist, or have existed in the past. Before the modern prescriptions system was created in 1951, the role of objective watchdog for drug safety and efficacy in the U.S. was handled by the American Medical Association (which maintained a private drug-testing laboratory and published annual guidebooks of drugs that received their seal of approval). They provided a system of voluntary, independent oversight that worked — until government “fixed” it.

Similarly, nobody that I know of is proposing that existing methods of accrediting doctors or other medical practitioners be abolished. Where would you get such a ludicrous notion? There’s already plenty of non-governmental means of accrediting doctors — among them, well, the doctoral degree in medicine, which is issued by medical schools and still would be issued by medical schools in a freed market, based on standards of training and mastery. Similarly for nursing degrees, certification by professional associations like the AMA, etc. What radical individualists oppose is not accreditation, but state licensure laws, which add an unnecessary layer of politically-directed licensing restrictions on top of already-existing, voluntary professional standards and certifications within the medical profesion. The problem with this is, first, that they are coercive, and hence violate the rights of patients and practitioners; and, second, that the standards for governmental licensure are imposed through political decision-making and legislative fiat, rather than being determined through open debate and consensus over best practices within the health care market.

As a result, they often use the force of the state to shut down debate and impose requirements that have nothing to do with medical fact and everything to do with political pull — as when state licensure laws were used to attack feminist women’s health centers, midwives, or other alternative medicine providers, even without any evidence that any identifiable patients had been harmed or were even dissatisfied with the service. Or, to return to our original topic, when state licensure laws were used to blackball doctors who were providing perfectly adequate care, but who were seen as “underselling” (that is, providing competent care at costs that were affordable by ordinary working people) during the political campaign against lodge practice in th 1910s and 1920s.

John:

The truth is that of all the industrialized countries, America is the only one with a private for profit system, …

Didn’t you read the article? “America” doesn’t have a private health care system. It has a government-imposed health care system. The market is dominated first, by direct government control, and, second, by the operations of a handful of corporate privateers who depend entirely on a combination of government subsidy and government-imposed barriers to entry for their day-to-day operations and long-term strategy.

A freed market in health care would look completely different from the “system” that you and I face today.

In a later comment, a different John — John de Laubenfels — writes:

Would you give companies that research and produce new drugs NO protection from competition,

You are correct that I do not believe that protectionism for pharmaceutical corporations is an adequate argument for imposing government-granted monopolies.

If you want to “protect” pharmaceutical companies’ existing business models, do so on your own dime by boycotting competitors and directing your money to first movers. (Hey, it worked for Tolkien.) But I’m not nearly so invested in protecting current business practices in the pharmaceutical industry, and I’d rather that you don’t use government monopoly to force your protections on my pocketbook.

John de Laubenfels:

starting the moment someone gets ahold of the new drug, analyzes it, and creates a knockoff? Nothing for all the money the original company has spent doing trials? I don’t think that such a system would be either fair or likely to motivate companies to produce new, life-saving drugs.

On the cost of doing drug trials, of course, in the same sentence where I advocated the abolition of patents I also specifically stated that I supported the abolition of the FDA, which would dramatically reduce the compliance costs involved in developing new drugs and bringing them to market. So I don’t know what you’re referring to here. (Of course, if companies want to do internal testing they can do so, but in voluntary independent oversight systems, the costs of running trials are typically assumed by the independent watchdog organizations themselves, as part of their institutional charter.)

However, if it turns out that it’s no longer profitable for big, for-profit corporations to do medical research, then — horrors! — it may just turn out to be the case that medical research has to be carried on by non-corporate or not-for-profit institutions. But I hear we have some of those. And I’m not typically impressed by broken-window arguments that fail to take any account of the value of the unseen alternative uses to which money might be put, if not for the coercive government intervention.

When the State gives doctors power over their patients, the doctors’ primary loyalty will be to the power of the State, not to their patients

(Via Cheryl Cline @ der Blaustrumpf 2008-12-02: Trusting Doctors.)

The first step is that the State grants legal privileges to doctors. Or, more specifically, to those doctors who practice medicine according to the approaches favored by the government and government-backed medical guilds like the American Medical Association. These privileges for officially-approved doctors to force their competitors out of business with threats of fines, jail, or death, and thus to force captive patients to seek their services. In many countries, these privileges include a large apparatus of government-subsidized healthcare, in which government-approved doctors are paid largely, or entirely, by funds that the government has taken from unwilling taxpayers. (Healers whose practices are not officially approved by the government, obviously, receive none of these subsidies.) In some cases, they also involve the power of doctors — especially psychiatrists, or other doctors treating children, or treating adults labeled as insane or feeble-minded — to force invasive treatment on unwilling patients through the use of deception, threats, restraint, and, if necessary, outright violence.

When the government gives doctors this kind of unaccountable, legally-backed plenary power to control or coerce their patients, it converts the medical profession into a class of legally elevated and legally regulated mandarins, who expect and enjoy considerable political power through their legally-privileged professional associations and through the State apparatus itself. Since doctors enjoy special privileges over their patients, and depend on legal force rather than on their patients’ judgment to get their way, the legal privilege helps foster a culture of arrogance and entitlement. And at the same time it creates a situation where doctors depend on government power for their wealth and cultural prestige, since they depend on it to create an artificial scarcity of medical services, and to keep patients captive to the doctor’s preferred regimen. Moreover, whenever medical doctors get special political privileges over their patients, politics defines what will be counted as legitimate medicine, and so medical doctors necessarily become politicians, acting a minor faction of the ruling class, just by establishing professional standards. When those professional standards are enforced by law, State-approved doctors’ professional associations are transformed from voluntary associations into a branch of the government, and medicine is transformed from a service to the patient into an arm of State policy.

And whenever, wherever, and exactly to the extent that the State gives doctors this kind of power over their patients, and makes them instruments of State policy, State-privileged doctors will owe their primary loyalty to power of the State, not to their patients.

The results of that shift in loyalty will depend on the nature of the State that claims their loyalty. When a State is relatively restrained, or simply incompetent, doctors will still help their patients, for the most part, rather than hurting them. When a State becomes more predatory, or lethal, politically-privileged doctors will be called on to be fine-tuned instruments of the predation or the murder. Since they depend on the State, politically-privileged doctors will usually answer the call, even if it means subjecting their victim-patients to malpractice, torture, or murder. Indeed, since a more powerful and invasive hygienic or therapeutic State means more power and influence for politically-privileged doctors, many of them will not only side with and collaborate with a predatory or lethal State, but will actively urge it onwards toward ever greater atrocities, and beg to be given the responsibility for carrying them out.



As Yoel Abells, a Toronto family doctor and medical ethicist, said of the experience in Germany under the Third Empire, and America under the United States government’s Global War on Terror:

One fact Abells found particularly disturbing was that doctors joined the Nazi Party in greater numbers than other professionals.

Almost half of all doctors were members of the Nazi Party, he said, compared with only a quarter of lawyers or musicians, and to the 9 per cent of the German population as a whole.

Joining Nazi groups, he said, was intoxicating for many doctors because of the power over life and death it gave them.

Today, Abells said, a disturbing number of doctors continue to be involved in genocidal campaigns, terrorist organizations, torture and the interrogation of prisoners of war.

A report in the New England Journal of Medicine in September found that the U.S. Army continues to use doctors in its interrogation of suspected terrorists, despite every major medical association condemning the practice.

— Stuart Laidlaw, HealthZone.ca (2008-11-05): Medical atrocities did not end with Nazi era

As Cheryl Cline writes:

The collusion of the medical profession with the State is certainly nothing new. And sadly, it is not all that surprising. Intuitively, the public trusts its doctors and others perceived as public servants more than it trusts, say, its lawyers or ad men. (The popular TV show Mad Men is a perfect example of capitalization on our distrust of the capitalist-minded. Can you think of a show that would portray doctors in a similar light?) With so many people putting blind faith in government bureaucrats to foster the public good, it’s hardly surprising to see the two entities take advantage of the public’s trust to merge and consolidate power.

— Cheryl Cline, der Blaustrumpf (2008-12-02): Trusting Doctors

When doctors have this unchecked power to wreak torture or death on patients — whether it’s thrust upon them by an aggressive State, or whether they collaborate with an ambitious State to get it — then you will always get atrocities. And that’s an outrage. But it should not be a surprise. It is not an abuse of power; the power itself is the abuse, and doctors will always and everywhere sweep aside their ethical obligations to patients in favor of political obedience to the State, as long as it is State power rather than patients’ consent that determines what counts as legitimate medical practice, and as long as State privilege transforms medical practice from a consensual service into a forcibly-wielded instrument of public policy — which is to say, an instrument of State power. Sometimes it happens in little, obnoxious ways (under little, obnoxious legal regimes), and sometimes it happens in big, deadly ways (under big, deadly legal regimes), but it’s been going on for a long time now, and there’s no way around it. No way, that is, except genuine freed-market medicine, the only thing that can free the medical profession from the influence of State power and to make doctors accountable to patients rather than to power. No way, that is, except to abolish all forms of political command-and-control over the practice of medicine and to let doctors return to providing nothing more, and nothing less, than a consensual, life-affirming service to willing patients.

See also:

State ownership of the means of reproduction. (#2)

(Via Miriam @ feministing 2008-06-18, via Feminist in Pink 2008-06-22.)

Here is the latest proposal from the American Medical Association, to have the government insist that every birth is properly institutionalized, so that they can make sure every birth leads to a fat and healthy hospital bill, with a proper Birth Guild-certified Expert looking over every midwife’s shoulder and between every expectant mother’s legs. And if the expectant mother doesn’t want that kind of a birth, well, she’d better learn to want it—or else.

  • Whereas, Twenty-one states currently license midwives to attend home births, all using the certified professional midwife (CPM) credential (CPM or lay midwives), not the certified midwives (CM) credential which both the American College of Obstetricians and Gynecologists (ACOG) and American College of Nurse Midwives (ACNM) recognize; and

  • Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film; and

  • Whereas, An apparently uncomplicated pregnancy or delivery can quickly become very complicated in the setting of maternal hemorrhage, shoulder dystocia, eclampsia or other obstetric emergencies, necessitating the need for rigorous standards, appropriate oversight of obstetric providers, and the availability of emergency care, for the health of both the mother and the baby during a delivery; therefore be it

  • RESOLVED, That our American Medical Association support the recent American College of Obstetricians and Gynecologists (ACOG) statement that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers (New HOD Policy); and be it further

  • RESOLVED, That our AMA develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, … (Directive to Take Action)

— American Medical Association, Resolution 205: Home Deliveries

Note especially the second Whereas; the AMA has, more or less explicitly, called for government force against home-birthing mothers because recent cultural trends suggest that women might be persuaded to choose otherwise if allowed to choose freely. The birth freedom group The Big Push for Midwives has this to say:

WASHINGTON, D.C. (June 16, 2008) — Just in time for Father’s Day, at its annual meeting last weekend, the American Medical Association (AMA) adopted a resolution to introduce legislation outlawing home birth, and potentially making criminals of the mothers who choose home birth with the help of Certified Professional Midwives (CPMs) for their families.

It’s unclear what penalties the AMA will seek to impose on women who choose to give birth at home, either for religious, cultural or financial reasons—or just because they didn’t make it to the hospital in time, said Susan Jenkins, Legal Counsel for The Big Push for Midwives 2008 campaign. What we do know, however, is that any state that enacts such a law will immediately find itself in court, since a law dictating where a woman must give birth would be a clear violation of fundamental rights to privacy and other freedoms currently protected by the U.S. Constitution.

Until the AMA proposed Resolution 205 on Home Deliveries, no state had considered legislation forcing women to deliver their babies in the hospital or limiting the choice of birth setting. Instead, states have regulated the types of midwives that may legally provide care. Currently, 22 states already license and regulate CPMs, who specialize in out-of-hospital maternity care and have received extensive training to qualify as experts in the types of risk assessment and preventive care necessary for safe and high-quality care for women who choose give birth at home. Certified Nurse Midwives (CNMs), who are trained primarily as hospital-based providers, are licensed in all 50 states and the District of Columbia.

The resolution did not offer any science-based information for the AMA’s anti-midwife or anti-home birth position.

Maternity care is a multi-billion dollar industry in the United States, said Steff Hedenkamp, Communications Coordinator for The Big Push for Midwives. So it’s no surprise to see the AMA join the American College of Obstetricians and Gynecologists in its ongoing fight to corner the market and ensure that the only midwives able to practice legally are hospital-based midwives forced to practice under physician control. I will say, though, that I’m shocked to learn that the AMA is taking this turf battle to the next level by setting the stage for outlawing home birth itself—a direct attack on those families who choose home birth, who could be subject to criminal prosecution if the AMA has its way.

— Press release, The Big Push for Midwives (2008-06-16): Father Knows Best Meets Big Brother Is Watching: Physician Group Seeks to Outlaw Home Birth—Is Jail for Moms Next?

For what it’s worth, I suppose it’s true that if the emanations and penumbras of the Bill of Rights provide for a right of privacy from government interference in adult women’s decisions to use contraception or abort a first-trimester pregnancy, they probably also provide for a right of privacy from government interference in where a woman chooses to give birth. And if a state should pass any of the AMA’s contemptible model legislation and somebody takes up the issue in federal court, I hope that they’ll win.

But setting aside the politico-legal maneuvering for the moment, should anyone really even care what the Constitution says about it? If the Constitution does authorize this kind of tyrannical state intervention in women’s reproductive choices, then to hell with the Constitution. The important argument here is the moral one, about what simple justice demands. And taken from the standpoint of simple justice for women, it is absurd that I should even have to sit here and type out, in so many words, that a birth experience rightly belongs to the woman who labors on it—not to the AMA, not to a hospital, and not to the State.

Of course it does. Christ. To hell with any know-it-all blowhard busybody, with any association of know-it-all blowhard busybodies, or with any document that says otherwise.

See also:

How physicians learned to stop worrying and love Big Pharma

You could also call this How Government Solved the Health Care Crisis, Part II; Part I being Roderick’s excellent article from 1993, on the government’s deliberate obstruction of mutual aid societies (in order to raise medical costs), and the havoc that it’s wreaked on the medical insurance system ever since.

As a follow-up in a similar vein, here’s an interesting bit I stumbled across in Robert Whitaker’s Mad in America (2002); the topic came up in the course of explaining how neuroleptics, and thorazine in particular — first marketed as chemical lobotomies, later repackaged as antipsychotics — took American psychiatry by storm during the 1950s. An essential part of the process was the destruction of private, independent oversight over the therapeutic value of drugs — a medical watchdog system that worked, until government fixed it.

After World War II, global leadership in drug development began to shift from Germany to the United States, and it did so because the financial opportunities in the United States were so much greater. Drug manufacturers in the United States could get FDA approval for their new medications with relative ease, since at that time they did not have to prove that their drugs were effective, only that they weren’t too toxic. They could also charge much higher prices for their drugs in the United States than in other countries because of strong patent-protection laws that limited competition. Finally, they could count on the support of the influential American Medical Association, which, as a result of a new law, had begun cozying up to the pharmaceutical industry.

Prior to 1951, the AMA had acted as a watchdog of the drug industry. In the absence of government regulations requiring pharmaceutical companies to prove that their medications had therepeutic merit, the AMA, for nearly fifty years, had assumed the responsibility of distinguishing good drugs from the bad. It had its own drug-testing laboratory, with drugs deemed worthwhile given the AMA seal of approval. Each year it published a book listing the medications it found useful. Drug companies were not even allowed to advertise in the Journal of the American Medical Association unless their products had been found worthy of the AMA seal. At that time, however, patients could obtain most drugs without a doctor’s prescription. Drug companies primarily sold their goods directly to the public or through pharmacists. Physicians were not, in essence, drug vendors. But in 1951, Minnesota senator Hubert Humphrey cosponsored a bill, which became the Durham-Humphrey Amendment to the Federal Food, Drug, and Cosmetics Act of 1938, that greatly expanded the list of medications that could be obtained only with a doctor’s prescription. While the amendment was designed to protect the public by allowing only the safest of drugs to be sold over the counter, it also provided doctors with a much more privileged status within society. The selling of nearly all potent medications now ran directly through them. As a result, drug companies began showering them, and their professional organizations, with their marketing dollars, and that flow of money changed the AMA almost overnight.

In 1950, the AMA received $5 million from member dues and journal subscriptions but only $2.6 million from drug-company advertisements in its journals. A decade later, its revenue from dues and subscriptions was still about the same ($6 million), but the money received from drug companies had leaped to $10 million—$8 million from journal advertisements and another $2 million from the sale of mailing lists. As this change occurred, the AMA dropped its critical stance toward the industry. It stopped publishing its book on useful drugs, abandoned its seal-of-approval program, and eliminated its requirement that pharmaceutical companies provide proof of their advertising claims. In 1961, the AMA even opposed a proposal by Tennessee senator Estes Kefauver to require drugmakers to prove to the Food and Drug Administration (FDA) that their new drugs were effective. As one frustrated physician told Kefauver, the AMA had become a sissy to the industry.

— Robert Whitaker, Mad in America (2002), pp.148–149

State Leftists who write on the medical industry routinely — rightly — talk up the corrupting effects that drug industry money and favors have had on the practice of medicine. But what they need to realize is that this is not some kind of disease endemic to a free market in medicine, or caused by the inevitable contamination from filthy lucre. Until 1951, there was no problem with drug companies bribing doctors to serve as drug-pushers; physicians’ organizations served as a system of voluntary, independent oversight on the claims of the drug industry — until, that is, the government shoved its way in to fix the problem of overhyped medication. What we found out is what we should have known all along: cartelization corrupts, and absolute cartelization corrupts absolutely.

EC OTC in OZ

Update: fixed typos and relocated the Extended Entry into the main text.

Here’s some more good news on the Emergency Contraception front: while the FDA process has advanced to the point where EC will probably be available over-the-counter sometime or another soon, Australia is quickly moving one step ahead of the United States: Emergency Contraception is set to become available over-the-counter in Australia tomorrow, January 1.

This isn’t to say that Australia’s EC situation is advanced over that of the United States in every respect. One major difference is that whereas the medical community in America largely supports the FDA’s move towards OTC availability, the medical community in Australia is at best nervous about the move, and in some cases directly opposed. The main issue for them, though, seems not to be the sort of religious Kulturkampf that flares around the American side of the debate. Rather, Australian doctors just seem to be more accustomed than American doctors to controlling the medical lives of their patients, and more jealous at giving up that power. For example, consider this Foucaultian bit of paternalism:

But Australian Medical Association president Bill Glasson said he was concerned that pharmacists were not legally required to record a woman’s visit.

I think that they really need to rediscuss how it is going to operate in the interest of good medical care, Dr Glasson said.

The pharmaceutical society’s national president, Jay Hooper, said many pharmacists would take it upon themselves to record each time a woman wanted the pill.

Not that American doctors don’t also sometimes engage in this tracking and scummy hectoring. At the Auburn University Student Health Center, for example, you could obtain EC—but they’d note when you got it, throw a bunch of red tape in your way, and if I recall correctly, they’d only let you have it once a semester. (The idea in both cases is for doctors to be able to lecture women that they decide are making unhealthy lifestyle choices. I am all for encouraging women to make healthy lifestyle choices, but I can’t imagine that an emergency situation to prevent a pregnancy is the appropriate time to do it, or that forcing women to listen by restricting access to EC until you’re done lecturing them is the appropriate way to go about it.) But the American medical community does not seem particularly squeamish about giving up that control if it means that women are more able to prevent unwanted pregnancies: the American Medical Association and the American College of Obstetricians and Gynecologists both lobbied for, and strongly supported, the FDA advisory panels’ decision. In Australia, however, the Australian Medical Association seems nervous and is ready to develop their own house guidelines to try to minimize the freedom it will offer women.

I don’t think, incidentally, that the attitude is a matter of misogyny, exactly. But it is directly connected to patriarchy—it’s a matter of the authoritarian sense of entitlement that modern doctors have always felt and acted out vis-a-vis their patients. The condition exists in Australia and America both, but with regard to over-the-counter pills the Australian medical community seems to have divorced itself from it less than their American counterparts. Consider: at the same time as EC becomes available over the counter for the first time in Australia, so will ibuprofen. And this has caused no small degree of consternation for the Australian Medical Association:

Also from Thursday stronger pain relief medication will be available in supermarkets, a move that has angered and confused doctors and pharmacists. Dr Glasson said the pain killer ibuprofen, contained in products including Nurofen, should only be sold under the supervision of pharmacists. It’s a dangerous move and it’s a backward step.

Patients have to look at the medical aspects of these drugs and get good advice that only the friendly pharmacist can give. Paracetamol is much kinder on the stomach.

Ibuprofen, an anti-inflammatory drug, was only available in pharmacies until the Government ratified the new regulations in October.

Products containing ibuprofen have been available in supermarkets in the US since 1984 and in Britain since 1996.

The teeming masses of Ozzies will now be able to buy Advil without a doctor’s learned advice! O tempora! O mores!

But however the doctors and pharmacists may whine, the women of Australia have every reason to celebrate. A happy New Year’s to the reproductive rights community in Australia — good show!